“What doesn’t kill you may make you weak”: Reflections on Mental health in the Black Community

We have all heard it before, “what doesn’t kill you makes you stronger” and although this may be true; when it comes to mental illness this may not be the case. For African, Caribbean and Black (ACB) Canadians, the struggle for mental health is often a silent one said Stacey-Ann Buchanan, an actress presenting her film the Blind Stigma at the Black Health Alliance “Sound Mind” Mental Health forum held on November 14, 2015. Mental illness is truly invisible however it doesn’t make it any less real for those who are affected. In fact 1 in every 3 Canadians experiences a mental health problem each year.

Mental health or well-being for African Canadians is a balanced and healthy outlook, attitude, behaviour and life practices that are consistently filled with joy, satisfaction, autonomy, a sense of purpose, a positive orientation, confidence, resilience, self-worth and a strongly affirmed racial, cultural and social identity.

While mental health revolves around health promotion and prevention of illness and dysfunction, mental illness refers to impairments in thinking that leads to significant distress and daily problems in living and may include chronic stress, stress-related trauma, and depressive symptoms. The severity of symptoms can range from mild to severe.

African Canadians are gripped by an unfolding mental health crisis and a deep crisis of identity. Research indicates that, Blacks access mental health services at a 50% late rate than any other group and this is concerning. However, late access to treatment and support must take into consideration the lack of cultural competence of mainstream mental health agencies, confusion about “westernized” concepts of mental health and illness, language barriers and racism. Dr. Kwame McKenzie, CEO of the Centre for Addiction and Mental Health (CAMH) speaking at the “Sound Mind” forum noted that, the “black population is under attack from racism and neglect”.

Racism is complex, functions at different levels and has serious cognitive, interpersonal, and environmental effects on individuals. Evidence shows that living in racialized countries can increase a person’s chance of developing anxiety and depression. Mental illness can be induced by direct and vicarious trauma connected with being witnesses and victims of unrelenting state violence, most vivid in police violence and brutality. The Black community’s disproportionate involvement in the criminal justice system, community and interpersonal violence only serves to exacerbate this plight. Furthermore, precarious employment, underemployment and poverty are risk-factors for poor mental health.

Blacks are plagued by a crisis of poor community leadership in mental health and very minimal holistic client-centred, anti-racist health prevention strategies, and limited community representation in planning and programming. As a result of these barriers many mental illnesses usually go unaddressed for the vast majority of Blacks, and often spiral into a whole range of other serious health problems including death. Culturally rooted stigma associated with mental illness and stereotypes about the “strong” Black woman and “machismo” for black men often prevent people from seeking help when required.

A report “Mapping the Mental Health System in Peel Region”, released by the United Way of Peel Region last year, noting gaps in the system indicate that, emergency departments which are often the first point of contact for patients experiencing mental health challenges have excessive wait times. In addition, most hospitals require that referrals into their outpatient programs come from general physicians and psychiatrists. For those who do not have access to general physicians, unfriendly policies like these perpetuate the cycle of people ending up in emergency service when they could be receiving community based supports. Navigating the mental health system can be complex and confusing further re-traumazing individuals who need help.

It is crucial and imperative to provide meaningful ways of averting this crisis. Helping the most vulnerable of the 116,225 Blacks in Peel means that, we must work to proactively to address policy issues related to allocation of funds and resources for first point of contact services to provide the needed support. Improved funding and creative collaborations with mental health organizations, Black communities and other service provides can allow for different stakeholders to play a coordinated role in the development and delivery of local mental health promotion and care strategies. Outreach can be expanded to deliver supports and services where people naturally congregate and improve access by ensuring cultural and linguistic competence.

Know someone who is experiencing mental health challenges?

Few resources are:

Children:

Connect with the school team that includes mental health nurses. Find additional resources at www.peelschools.org